Abstract：
:Transplant pharmacotherapy evolves as new agents are investigated and approved for use. Clinical immunosuppression has been plagued with maintaining a balance between rejection of the transplanted organ and complications of over-immunosuppression, including infection and malignancy. Clinicians must understand current immunosuppressive regimens and their associated effects when caring for transplant patients. While all transplant patients receive some form of immunosuppressive therapy, the combinations and choices increase as new drugs are developed. In the critical and acute care settings, newly transplanted patients will likely receive induction therapy. The goal of induction therapy is to increase long-term patient and allograft survival while preventing or reducing rejection episodes. Several agents are available for induction therapy, and each transplant center designs its own protocol. The foundation for maintenance therapy rests on the combining immunosuppressives to prevent rejection through a variety of pathways. An understanding of the mechanism of action and additive effects of a drug allows practitioners to optimize therapy while decreasing adverse effects. Immunosuppressive therapy offers potential for reducing detrimental patient outcomes and improving allograft survival. It is well established that repeated rejection episodes correlate with poor long-term graft survival. Challenges facing researchers and clinicians focus on improved patient outcomes and options to address financial constraints of transplantation.
journal_name
Crit Care Nurs Clin North Amjournal_title
Critical care nursing clinics of North Americaauthors
Sims TW,Good EWdoi
10.1016/s0899-5885(03)00041-8subject
Has Abstractpub_date
2002-03-01 00:00:00pages
99-109issue
1eissn
0899-5885issn
1558-3481pii
S0899-5885(03)00041-8journal_volume
14pub_type
杂志文章,评审abstract：:A multisite APN role presents a unique perspective. You may see this in terms of opportunities or as frustrations. Ultimately it is your response, not the situation, that determines the outcome. As with any major transition, it can be a catalyst to transform yourself and reenergize your practice. Careful attention to ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/s0899-5885(02)00012-6
更新日期：2002-09-01 00:00:00
abstract：:Nutrition in acute spinal cord injury is complicated. Not every aspect of nutrition as it relates to the acutely injured spinal cord patient is known. The stress response to injury, fever, infection, sepsis, and surgery alter nutritional needs, as does the spinal cord injury itself. The sequelae of spinal cord injury,...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:Liver transplantation has evolved into an accepted treatment for many suffering from end-stage liver failure. The complex nature of the liver results in every organ system being impacted by either the failing or the transplanted liver. Organ shortage remains problematic, and work to ensure maximizing the organ donor p...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2011.08.002
更新日期：2011-09-01 00:00:00
abstract：:The high-tech homecare nurse is operationalizing the trend to bring critical care nursing and medical services directly to the homecare environment. With the continuing advancement in technologic capability, the role of this newly emerging critical care nurse clinician will grow in scope of practice. As the health car...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1998-09-01 00:00:00
abstract：:The nutritional needs of the bum-injured patient are exaggerated and change constantly with the patient's stage of convalescence. Nurses working closely with other members of the health care team, specifically the nutritional specialist, can positively affect the patient's survival by optimizing the nutritional assess...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2003.09.004
更新日期：2004-03-01 00:00:00
abstract：:In most inpatient settings, the complexity of care required by individual patients coupled with the wide range of services provided within a single institution mean patients are routinely cared for in highly specialized units. Service lines, such as surgical services; intensive care; emergency services; and maternity,...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2010.03.008
更新日期：2010-06-01 00:00:00
abstract：:The incidence of gastrointestinal trauma is low in comparison with solid organ injury to the abdomen. The most commonly injured organs are the small bowel and colon. Knowledge of the mechanism of injury alerts the nurse to areas of potential injury and guides the clinical examination. Because of the delayed presentati...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-03-01 00:00:00
abstract：:This article presents an overview of the focused subjective and objective assessment of the older adult for the critical care nurse. Discussion includes the distinguishing features inherent to older adults, and relevant evidence-based screening tools that the nurse can use in assessing the critically ill older adult. ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2013.09.006
更新日期：2014-03-01 00:00:00
abstract：:To sustain optimal pain-relieving care for acutely and critically ill patients, organizations must have systems in place to support evidence-based interventions, facilitate expert practice in the area of pain management, and encourage ongoing communication among patients, families, and providers. The key to success ma...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2001-06-01 00:00:00
abstract：:Acute respiratory distress syndrome (ARDS) represents the ultimate pulmonary response to a wide range of injuries, from septicemia to trauma. Optimal nutrition is vital to enhancing oxygen delivery, supporting adequate cardiac contractility and respiratory musculature, eliminating fluid and electrolyte imbalances, and...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2004.04.001
更新日期：2004-09-01 00:00:00
abstract：:Ablative therapy for treatment of tachycarrhythmias has developed rapidly in recent years due to an increased understanding of electrophysiologic mechanisms of arrhythmogenesis and improved modalities of destroying or isolating arrhythmogenic tissue. Radiofrequency catheter ablation is currently the most frequently pe...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：:Pulmonary embolism is the leading cause of maternal death in the United States. Amniotic fluid embolism (AFE) represents the least preventable and most lethal of complications with a reported mortality of 86% and an associated fetal demise of 50%. Although it is widely accepted as a clinical entity, AFE is incompletel...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1992-12-01 00:00:00
abstract：:It is clear that as a chronic illness, heart disease can create multiple stressors for women, including limitations on the performance of daily activities, difficulties managing symptoms and treatment, changes in role performance, lack of social support, and a reduced quality of life. Although available studies provid...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1997-12-01 00:00:00
abstract：:To improve the past statistics of high mortality and morbidity in patients with TEN, definitive measures are required. Early referral and transfer to a burn center and withholding or withdrawing steroid therapy are two crucial factors. Therapeutic goals must be directed toward promotion of wound healing; correction of...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：:Ethically challenging situations are an increasing phenomenon in the nurse's environment, and literature on the subject is growing. Morally challenging experiences common in the critical care environment include end-of-life situations, barriers to providing the best care possible, and lack of organizational resources....
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2020.05.002
更新日期：2020-09-01 00:00:00
abstract：:Dating from the inception of percutaneous coronary angioplasty, restenosis has been the postprocedural Achilles heel. Despite a decade of research, with a myriad of mechanical devices and pharmacologic agents, this vexing problem has yet to be resolved. Although intracoronary stents have proved effective at restenosis...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1999-09-01 00:00:00
abstract：:In the move to increase effectiveness in valued-based organizational cultures, mindfulness leaders are charged to create environments that foster curiosity and creativity in uncertain times. Mindfulness increases situational awareness and improved communication enhances a culture of safety and better patient outcomes....
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2019.02.003
更新日期：2019-06-01 00:00:00
abstract：:Advances in technology have resulted in a plethora of invasive neuromonitoring options for practitioners to manage while caring for the complex needs of the critical care patient. Although many types of invasive neuromonitoring are available to the practitioner, intraparenchymal monitors and external ventricular devic...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2015.10.001
更新日期：2016-03-01 00:00:00
abstract：:The adult intensive care unit (ICU) at Baystate Medical Center is a 24-bed medical-surgical-trauma ICU that provides high-quality care to critically ill patients. Collaboration and expertise among the nursing staff, intensivists, and interdisciplinary colleagues have contributed to its development into a Beacon Award-...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2005.01.005
更新日期：2005-06-01 00:00:00
abstract：:Arterial cannulation, while common in critical care, is a procedure with attendant risks of complications. Anecdotal data from the American Association of Critical Care Nurses' Thunder Project provided evidence that catheters, insertion sites, and monitoring systems continue to be sources of complications. The problem...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：:This article reviews the nursing care of the patient who receives a lung transplant, starting with preparation for admission to the ICU. Issues of oxygenation, airway clearance, hemodynamic and fluid assessment, infection control, incisional assessment, and pain are addressed throughout the hospitalization. Emotional ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-09-01 00:00:00
abstract：:Many older patients in critical care settings have significant arterial disease, so the assessment of peripheral circulation may be important in their management. A great deal of information can be gained through the physical examination, which can be supplemented by the use of the Doppler velocity detector. This devi...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-09-01 00:00:00
abstract：:A fearful stranger to the healthcare sector when she became a frequent user 2 years ago, Goeltz clearly is now a sophisticated and creative partner. She is fully engaged in decision-making and holds the decisions made as her own. Physicians often worry that their patients don't fully consent to the treatment given the...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/s0899-5885(02)00033-3
更新日期：2002-12-01 00:00:00
abstract：:Critical care nurses work in challenging environments that are often sterile, impersonal, noisy, and frightening to patients and their families. Nurses act as liaisons between medical professionals and patients and their families in multiple specialty intensive care units. Critical care nursing practice, guided by the...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2019.07.009
更新日期：2019-12-01 00:00:00
abstract：:It is well-documented in the literature that infants who suffer from hypoxic ischemic encephalopathy are at high risk for neurologic sequelae or even death. With the addition of therapeutic hypothermia into the treatment regimen for neonatal hypoxic ischemic encephalopathy, newborns afflicted with hypoxic ischemic enc...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2018.07.007
更新日期：2018-12-01 00:00:00
abstract：:Inflammation is a physiologic response to irritants, injury, and infection. Inflammatory dysregulation is believed to contribute to mortality and morbidity in illnesses common to critical care units, such as burns, trauma, sepsis, and cardiovascular disease. This article reviews the approaches used to investigate the ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2008.01.007
更新日期：2008-06-01 00:00:00
abstract：:Patient competence is a prerequisite to fulfilling the primary ethical principle of patient autonomy or self-determination. This article defines the legal designation of incompetence and describes the components of the assessment of a patient's decision-making capacity. These assessments occur within the context of re...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:Because of their diverse education, experience, and practice settings, nurses are uniquely qualified to be first receivers, care givers, and leaders in any large-scale public health emergency. Many nurses, however, continue to feel inadequately prepared to function effectively in these types of situations. Great strid...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2007.10.008
更新日期：2008-03-01 00:00:00
abstract：:In critical care, nurses are expected to react quickly to urgent and emergent situations. It is imperative that nurses have the ability to recognize signs and symptoms in patients that require diagnostic intervention. This article begins with a brief description of angiography and its role in the critical care environ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2009.10.007
更新日期：2010-03-01 00:00:00
abstract：:Patients with chronic liver diseases sustain impairment to immune systems, which worsens over time. These defects in their host defense lead to risks of bacterial infections and increased morbidity. Providers should have heightened surveillance for infectious diseases and suspect one with any acute change in status. P...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2010.04.002
更新日期：2010-09-01 00:00:00
